How to Choose a Facial Filler

Facial fillers, also known as dermal fillers, are used to temporarily make a person's face appear rested, rejuvenated, and younger. These injections can plump thinning lips, give eyebrows a lift, enhance cheekbones, erase under-eye circles, and smooth smile lines.

Dermal fillers can be injected in less than an hour and require little to no downtime afterward. Side effects can include mild bruising, swelling, or redness at the injection site, but serious side effects—including skin or other tissue damage or vision loss—can occur.

How to Choose Before You Use

There are many dermal filler products on the market. Finding the right one for you will depend on your budget, your healthcare provider's experience and preference, and your individual skin nuances—how much sun damage you have, for instance, or how elastic or inelastic your skin is.

Keep in mind that what works for your friend may not be the best option for you. If you're thinking of having this procedure, there are some key things to know about some of the most-used dermal fillers.

Fillers vs. Relaxers

Don't confuse dermal fillers with other injectables like Botox, Dysport, or Xeomin, which are wrinkle relaxers. Although, like fillers, these products are injectables, they work very differently—by temporarily paralyzing muscles that cause crow's feet, forehead furrows, and the "eleven" lines between the eyebrows.

They don't fill, plump, or enhance an area. They can, however, be used along with fillers.

Juvéderm

man receiving facial injection

Adam Gault / Science Photo Library / Getty Images

Juvéderm is a collection of fillers, and different forms are designed to be used in different areas of the face.

Juvéderm Voluma XC is used to add back youthful contours to the cheeks, which naturally flatten over time. It also smoothes moderate-to-deep "parentheses" lines around your nose and mouth (aka the nasolabial folds) and the lines that run from the corners of your mouth toward the chin (the marionette lines).

Juvéderm Ultra XC plumps up the lips, as does Juvéderm Volbella XC, which also is used to soften vertical lip lines. Though not totally painless, most HA fillers are infused with the anesthetic lidocaine to minimize discomfort during and after treatment.

How It Works

The main ingredient in Juvéderm is hyaluronic acid (HA), a naturally occurring sugar found in the body that gives the skin moisture, volume, and elasticity. As HA gets depleted with age, skin loses volume and wrinkles are more likely to appear.

When injected, HA acts like a sponge to attract water into the skin. As a result, it plumps up the area in which it was injected. In addition to producing instant smoothing results, research from 2007 shows that HA injections boost the skin's own production of collagen.

That means fewer touch-ups may be needed, and that less of the material will be necessary (so repeat treatments should be cheaper). One advantage of HA-based fillers is that HA is found naturally in the body, so there's no risk of an allergic reaction.

How Long It Lasts

Depending on the material (some are thinner and more "flowy," others thicker, so they can potentially last longer), the effects of Juvéderm can last from six months to 18 months before the body gradually absorbs the material.

If you're wondering what happens if you don't love your result, fear not: Fillers that contain HA can be partially or completely removed with hyaluronidase, an enzyme that breaks down HA.

Price

According to 2017 stats from the American Society of Plastic Surgeons (ASPS), the average cost of an HA-based filler injection is $682.

Restylane

Like Juvéderm, there's a family of Restylane products designed to treat various, sometimes overlapping, problem areas. The original Restylane smoothes away wrinkles and folds and can be used to add volume to thin lips.

Restylane Lyft (formerly Perlane-L), a much thicker gel, is used to correct severe wrinkles and folds like the nasolabial folds, as well as volume loss in the cheeks. It's also FDA approved to add fullness to the backs of the hands.

Restylane Silk is designed especially to enhance the lips, as it is made with smaller particles than the other products.

How It Works

This is another line of products that rely on the immediate smoothing ability of hyaluronic acid. Injections may also stimulate natural collagen production, so fewer touch-ups may be needed and less material necessary when they are.

How Long It Lasts

Clinical studies found that with "full treatment," which includes one repeat injection, results with Restylane can last up to 18 months. Results in the cheeks last up to a year and up to six months in wrinkles and folds with Restylane Lyft. Results in the lips last up to six months with Restylane Silk.

Price

According to 2017 stats from ASPS, the average cost of this filler is $682.

Sculptra Aesthetic

Sculptra initially was used in patients with human immunodeficiency virus (HIV) who had loss of facial fat. Now it's approved for cosmetic use by any person who wants to build up cheeks, fill in hollows or sunken areas of the face, and increase skin thickness to diminish the appearance of folds and lines. It is not injected into the lips or used around the eyes.

How It Works

The active ingredient in Sculptra is poly-L-lactic acid (PLLA), a synthetic compound that encourages the formation of new collagen. For this reason, it takes several treatments, about four to six weeks apart, for results to become obvious. The number of treatments a person needs will depend on the extent of facial aging.

How Long It Lasts

In a clinical study published in 2011, the effects of Sculptra lasted up to two years after the first treatment session was completed (an average of three injections).

Price

According to 2017 stats from the ASPS, the average cost of Sculptra injection is $903.

Radiesse

Radiesse is used to treat moderate-to-severe facial creases, such as the nasolabial folds. It also can be used to plump up cheeks and other facial contours. It's not used on the lips.

How It Works

Radiesse contains microspheres of calcium hydroxylapatite, a type of mineral that's found in human teeth and bones. When used in a filler, the calcium particles are tiny and suspended in a thick gel-like solution.

While Radiesse immediately replenishes lost volume, over time the gel is absorbed and the body metabolizes the calcium, leaving behind your own collagen.

How Long It Lasts

Results with Radiesse last a year or more. However, because calcium hydroxylapatite stimulates natural collagen production, fewer touch-ups (and less material) may be necessary to maintain the result.

Price

According to 2017 stats from the ASPS, the average cost of having Radiesse injection is $662.

Frequently Asked Questions

How long do side effects last after facial fillers?

According to the American Academy of Dermatology, the side effects of facial fillers tend to go away in seven to 14 days. Sometimes, they may not even last that long.

Can facial fillers improve facial asymmetry?

Facial fillers can significantly improve facial asymmetry from many causes, including:

  • Facial nerve paralysis
  • Ramsey Hunt syndrome
  • Bell's palsy
  • Skull injuries

How can I reduce swelling and bruising after facial filler injection?

To minimize swelling and bruising:

  • Apply ice or cold packs on the areas where the filler was injected to reduce inflammation and bruising.
  • Refrain from intense physical activity for between 24 and 48 hours after the injection.
  • Massage the areas to improve blood flow.

How many days should you sleep on your back after getting facial fillers?

Some healthcare providers and plastic surgery clinics recommend sleeping on your back, with your head elevated, for three nights after filler injections. They say it will help the filler stay where you want it.

Can facial fillers make your face look puffy rather than younger?

Some people do report looking puffy after getting facial fillers. This may be the result of getting too much of the filler or getting filler too frequently, which can stretch out the skin and leave it saggy. Some research recommends that healthcare providers inject small amounts at a time and have you smile regularly during the procedure to make sure no area is being overfilled.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Board of Cosmetic Surgery. Injectable fillers guide.

  2. Wang F, Garza LA, Kang S, et al. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol. 2007;143(2):155-63. doi:10.1001/archderm.143.2.155

  3. Bogdan allemann I, Baumann L. Hyaluronic acid gel (Juvéderm) preparations in the treatment of facial wrinkles and folds. Clin Interv Aging. 2008;3(4):629-34. doi: 10.2147/cia.s3118

  4. American Society of Plastic Surgeons. Dermal fillers minimally invasive procedures.

  5. Vleggaar D, Bauer U. Facial enhancement and the European experience with Sculptra™ (poly-l-lactic acid)Journal of Drugs in Dermatology. 2004;3(5):542-547.

  6. Brown SA, Rohrich RJ, Baumann L, et al. Subject global evaluation and subject satisfaction using injectable poly-L-lactic acid versus human collagen for the correction of nasolabial fold wrinkles. Plast Reconstr Surg. 2011;127(4):1684-92. doi:10.1097/PRS.0b013e318208d371

  7. Jansen DA, Graivier MH. Evaluation of a calcium hydroxylapatite-based implant (Radiesse) for facial soft-tissue augmentation. Plast Reconstr Surg. 2006;118(3 Suppl):22S-30S, discussion 31S-33S. doi:10.1097/01.prs.0000234903.55310.6a

  8. American Academy of Dermatology Association. Fillers: FAQs.

  9. Heydenrych I. The treatment of facial asymmetry with Botulinum toxin: Current concepts, guidelines, and future trendsIndian J Plast Surg. 2020;53(2):219-229. doi:10.1055/s-0040-1715189

  10. American Society of Plastic Surgeons. Dermal fillers: Minimally invasive procedures.

  11. Cotofana S, Gotkin RH, Frank K, Lachman N, Schenck TL. Anatomy behind the facial overfilled syndrome: The transverse facial septumDermatol Surg. 2020;46(8):e16-e22. doi:10.1097/DSS.0000000000002236

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